Ageing and disability: a comparative analysis of developed and developing countries

Kenya V. Noronha, Universidade Federal de Minas Gerais
Malena Monteverde, Northwestern University
Alberto B. Palloni, Northwestern University

Population ageing is a phenomenon affecting both developed and developing countries, albeit with sharp differences in speed, levels, determinants, and social contexts. There are a number of conjectures that suggest that the aging process in countries of Latin American and the Caribbean (LAC) will be profoundly different from those experienced by more developed countries. In particular, these conjectures suggest that the overall levels of frailty of the elderly and their associated levels of mortality will be worse, even after controlling for differences in standards of living. The objective of this study is to marshal evidence that tests this conjecture. For this purpose we study age-adjusted disability prevalence rates among elderly in countries of LAC regions, Europe and the US. We use microdata for LAC countries, the US and European countries from a group of surveys that employed comparable protocols. Since the information we use is based on self-reported conditions we introduce a battery of novel instruments to detect and reduce biases rooted in the heterogeneity of perceptions that may influence and the self reports. Preliminary analysis carried out for selected LAC countries reveal much higher disability prevalence among elderly in Puerto Rico (38%) when compared with those in Buenos Aires (33%) and Mexico (20%). The most likely explanation for the observed differentials is the existence of substantial differentials in the prevalence of disabling chronic conditions such as severe cognitive problems, obesity, diabetes, hypertension, cancer, respiratory diseases and stroke. The heterogeneity in chronic conditions is likely to be associated both differentials in current exposure and, perhaps more importantly, sharp differentials in the exposure these conditions experience during early childhood. In this paper we quantify the roles of these conditions and produce estimates for LAC that can be compared with estimates from the US and selected European countries.